Looking Into Recent Suicide Rates and Trends in Malaysia: A Comparative Analysis

Background: Suicide is a preventable cause of death. Examining suicide rates and trends are important in shaping national suicide prevention strategies. Therefore, the objectives of this study were to analyze age-standardized suicide trends of Malaysia between 2000 and 2019 using the WHO Global Health Estimates data, and to compare the 2019 rate with countries from the Association of South-East Asian Nations (ASEAN), Muslim majority countries, and the Group of Seven (G7).Methods: The age-standardized suicide rates data were extracted from the WHO Global Health Estimates. We calculated the average age-standardized suicide rates of the last 3 years from 2017 to 2019. Joinpoint regression analysis was conducted to calculate the average annual percentage change (APC) of the age-standardized suicide rates in Malaysia from 2000 to 2019.Results: Between 2000 and 2019, the minimum and maximum suicide rates for both sexes in Malaysia were 4.9 and 6.1 per 100,000 population respectively, whilst the past 3-year (2017–2019) average rates were 5.6, 8.8, and 2.4 for both sexes, males, and females, respectively. The suicide rates decreased significantly for both sexes between 2000 and 2013. Between 2014 and 2019, the suicide rates increased significantly for males. In 2019, Malaysia recorded the rate of 5.8 per 100,000 population, with an estimated 1,841 suicide deaths, i.e., ~5 deaths per day. The Malaysian suicide rate was the second highest amongst selected Muslim majority countries, in the middle range amongst ASEAN countries, and lower than all G7 countries except Italy.Conclusions: There is a need to further explore factors contributing to the higher suicide rates among Malaysian males. In light of the rising suicide rates in Malaysia, national mental health and suicide prevention initiatives are discussed and the importance of high-quality suicide surveillance data is emphasized.

Psychodynamic Psychiatry in the Philippines

The authors describe the practice of psychodynamic psychiatry in the Philippines. They review features of contemporary psychodynamic psychiatry, the state of psychodynamic psychiatry in training programs, and its integration in national professional societies. Despite psychodynamic psychiatry's wide acceptance in the professional community in the Philippines and neighboring Southeast Asian countries, delivery of care to over 110 million residents of the archipelago requires creativity given the small number of psychiatrists. The authors discuss how psychodynamic psychiatry impacts the national mental health scene and propose future directions involving forging international linkages.

Clinical update on public and private psychiatric practice shared-care partnerships – Can the twain work together?

Objective: We explore the previous research and current context regarding opportunities for shared-care partnerships between public and private psychiatric practice. Conclusions: Since the early 2000s, when there was impetus for the development of public-private psychiatric shared-care models as part of a previous National Mental Health Strategy, there has been surprisingly little research and policy development. Given an apparent exodus of psychiatrists to private practice due to current challenges facing the public health sector, it is timely to reconsider models of private and public sector shared-care that may improve the quality of public mental healthcare.

History of psychiatry in Nepal

The history of psychiatry as a discipline in Nepal has been poorly studied. We have attempted to summarise historical landmarks to explore how it began and its evolution over time in relation to contemporary political events. Although Nepal has achieved several milestones, from establishing a psychiatric out-patient department with one psychiatrist in 1961 to having more than 500 psychiatric in-patient beds with 200 psychiatrists by 2020, the pace, commitment and dedication seem to be slower than necessary: the current national mental health policy dates back to 1996 and has not been updated since; there is no Mental Health Act; the number of psychiatric nurses and in-patient psychiatric beds has increased only slowly; and there is a dearth of professional supervision in rehabilitation centres. Thus, despite making significant progress, much more is required, at greater intensity and speed, and with wide collaboration and political commitment in order to improve the mental health of all Nepali citizens, including those living in rural areas and or in deprived conditions.

Mental health law in Nepal

During the past three decades Nepal has gone through series of reforms to address the mental health needs of the Nepalese population by promulgation of an exclusive National Mental Health Policy and related Strategic Action Plan. Small but significant improvements have been achieved in Nepal with regard to mental health policies and plans. This article discusses the evolution of mental health policies in Nepal and analyses the challenges to be overcome for their effective implementation.

Proportion of U.S. Clinics Offering LGBT-Tailored Mental Health Services Decreased Over Time: A Panel Study of the National Mental Health Services Survey

Our objective was to characterize the proportion of U.S. mental health clinics that offered LGBT-tailored mental health services between 2014 and 2018. We used data from the National Mental Health Services Survey (NMHSS) to construct a mixed logistic model of availability of LGBT-tailored mental health services over time, by region (Northeast, South, Midwest and West), and by facility type (Veterans Administration, inpatient/residential, outpatient, community mental health centers and mixed). Our results show that the overall proportion of mental health clinics that offered LGBT-tailored services decreased from 2014 to 2018. Our results also indicate that Veteran Affairs clinics and facilities in the West and Northeast were most likely to offer LGBT-tailored mental health services. Given the temporal, regional, and facility gaps in LGBT-tailored mental health services availability, more effort should be dedicated to addressing this disparity.

1494Content Analysis and Predicting Survey Refusal: What Are Respondents’ Concerns about Face-to-face Mental Health Survey?

Background Previous studies suggest that refusals form the largest proportion of nonresponse for household surveys. As face-to-face household health surveys are uncommon in several countries, it might be advantageous for prospective surveys to preemptively tackle respondents’ refusal to survey participation. Methods Using contact history data from the Saudi National Mental Health Survey, we examined the relationship between social environmental factors, respondent characteristics, survey request concerns recorded by interviewers, and respondents’ propensity to refuse to participate in the survey. Content analysis and logistic regressions were conducted. Results Our findings suggest that urbanicity, region, socioeconomic status, age, and gender are associated with refusal. Patriarchal gatekeepers and specific survey-related concerns are more likely to lead to temporary refusals compared to final refusals. Conclusions These results have implications for survey researchers employing similar recruitment and data collection methods, for example in tailoring refusal conversion strategies for interviewers to address concerns expressed by Saudi and/or culturally similar respondents. Key messages Results might benefit studies considering similar methods and investigating sensitive issues, improve response rates, and combat the declining trend that potentially jeopardizes the quality of survey data collected.